ISSUE NOVEMBER MEDICARE PRESCRIPTION DRUG PLANS FOR PEOPLE WITH

ISSUE #2 ~ NOVEMBER 8, 2006 MEDICARE PRESCRIPTION DRUG PLANS FOR PEOPLE WITH HIV/AIDS Everyone with Medicare, regardless of income and resources, health status or current prescription expenses, will have access to prescription drug coverage beginning on January 1, 2006. What is Medicare prescription drug coverage? Medicare prescription drug coverage is insurance that covers both brand-name and generic prescription drugs at participating pharmacies. Medicare prescription drug coverage provides protection for people who have very high drug costs. If you have a limited income and few resources, and you qualify for extra help, you may not have to pay a premium or deductible. Why should I get Medicare prescription drug coverage? Medicare prescription drug coverage provides greater peace of mind by protecting you from unexpected drug expenses. Even if you don't use a lot of prescription drugs now, you should still consider joining. As we age, most people need prescription drugs to stay healthy; joining now means protecting yourself from unexpected prescription drug bills in the future. the full low-income subsidy will continue to qualify for the THMP to access their HIV medications as long as they are also enrolled in a Medicare Rx plan and continue to meet THMP program eligibilRemember: If you have drug coverage through a previous or current employer or union, contact your benefits administrator before you make any changes to your prescription drug coverage. How does Medicare prescription drug coverage work? Your decision about Medicare prescription drug coverage depends on the kind of health care coverage you have now. There are two ways to get Medicare prescription drug coverage. You can join a Medicare Rx plan or you can join a Medicare Advantage Plan or other What if I have limited income Medicare Health Plans that of- and can’t afford a Medicare Prescription Drug Plan? fer drug coverage. There is extra help for people Like other insurance, if you with a limited income and rejoin, you will pay a monthly pre- sources. Almost 1 in 3 people mium, which varies by plan, with Medicare will qualify for and a yearly deductible (no the full low-income subsidy and more than $265 in 2007). You Medicare will pay for almost all will also pay a part of the cost of their prescription drug costs. of your prescriptions, including a co-payment or coinsurance. Texas HIV Medication ProCosts will vary depending on gram (THMP) clients are rewhich drug plan you choose. quired to enroll in a Medicare Some plans may offer more Prescription Drug Plan. coverage and additional drugs Individuals who are not dual for a higher monthly premium. eligible and do not qualify for What’s Inside: Q&A Things to Consider Cost Breakdown Extra Help Formulary Information Example worksheet My worksheet Plan Information Drug list Notes Additional Resources References and Acknowledgements 1 2 3 4 5 6 7 8 11 14 15 16 MEDICARE PRESCRIPTION DRUG PLANS Page 2 Things to Consider To get Medicare coverage for your prescription drugs, you must choose and join a Medicare drug plan. Regardless of how a drug plan offers this coverage, there are some key factors that may vary by plan. Some of these factors might be more important to you than others, depending on your situation and drug needs. These factors are: COST Premium: This is the monthly cost you pay for a Medicare drug plan. Deductible: This is the amount you pay for your prescriptions before your plan starts to share in the costs. No plan may have an annual deductible greater than $265 in 2007 and not every plan will have a deductible. Co-payments and Coinsurance: This is the amount you pay for your prescriptions after you have paid the deductible (if applicable). In some plans, you pay the same co-payment (a set amount) or coinsurance (a percentage of the cost) for any drug. In other plans, there might be different levels, called "tiers", with different costs. (For example, you might pay less for generic drugs than brand names, or some brand names might have a lower copayment than other brands.) In some plans your costs can increase when your prescription costs reach a certain limit. that work just as well. Other drugs may have more side effects, or have restrictions on how long they can be taken. To be sure certain drugs are used correctly and only when truly necessary, plans may require a "prior authorization." This means before the plan will cover these prescriptions, your doctor must first contact the plan and show there is a medicallynecessary reason why you must use that particular drug for it to be covered. Plans might have other rules like this to ensure that your drug use is effective. For example, Fuzeon will require prior approval by your plan. Coverage Gap: If you have high drug costs, you may consider which plans offer additional coverage until you spend $3,850 out-ofpocket. In some plans, if your costs reach an initial coverage limit, then you pay 100% of your prescription costs. This is called the coverage gap (informally referred to as the donut hole). This "gap" in coverage is generally above $2,400 in total drug costs until you spend $3,850 out-of-pocket. Some plans might offer some coverage during the gap such as generics. Even in plans where you pay 100% of covered drug costs after a certain limit, you would still pay less for your prescriptions than you would without this drug coverage. COVERAGE Formulary: The list of drugs that a plan covers is called a formulary. Formularies include generic and brand name drugs. Most prescription drugs used by people with Medicare will be on a plan's formulary. The formulary must include at least two drugs in categories and classes of most commonly prescribed drugs to people with Medicare. This ensures that people with different conditions get the treatment they need. All retrovirals are covered on all of the Medicare prescription drug plans and do not require prior approval. Prior Authorization: Some drugs are more expensive than other less expensive drugs CONVENIENCE Drug plans must contract with pharmacies in your area. Check with the plan to make sure they contract with your preferred pharmacy or that a pharmacy in the plan is convenient to you. Also, many plans offer a mail-order program that will allow you to have drugs sent directly to your home. You should consider all of your options in determining what is the most cost-effective and convenient way to have ISSUE #2 ~ NOVEMBER 8, 2006 Page 3 Breakdown of Costs by Eligibility Also see page 4 for important information about applying for Extra Help to pay for your medications. Group 1 Full Dual Eligible Medicaid or SSI Group 2 Partial Dual Eligible MQMB, QMB, SLMB, QI** Group 3 – Medicare Only Qualifies for Full Subsidy Income below 135% of FPL* and resources below $6,000 $0 $0 Co-pay: $2.15 generic, $5.35 brand No coverage gap: Continue to pay co-pay up to $3,850 in costs Qualifies for Partial Subsidy Income below 150% of FPL* and resources below $10,000 Not Qualified for Subsidy Income above 150% of FPL* Eligibility Premium Deductible $0 $0 $0 $0 Co-pay: $2.15 generic, $5.35 brand No coverage gap: Continue to pay co-pay up to $3,850 in costs Discounted, but Average $37 a varies month Sliding scale $0-$53 15% coinsurance (% of Rx costs) $265 25% coinsurance (% of medication costs) Initial Coverage PeCo-pay: riod (deductible met $1 generic, to $2,400 in Rx $3.10 brand Costs) Coverage Gap (Between $2,400 and $5,451 in Rx costs) No coverage gap: Continue to pay co-pay up to $3,850 in costs No prescription No coverage drug coverage – gap: Continue to responsible for pay 15% up to 100% of drug $3,850 in costs costs Co-pay: $2.15 generic, $5.35 brand The greater of: $2.15 generic, $5.35 brand or 5% Catastrophic Coverage (after $3,850 in $0 out-of pocket costs) Changes to THMP Eligibility $0 $0 Expected to access Prescription Drug Plans for all medications, will be transitioned off of THMP Assistance with co-pays. Estimated: $15 a month for 4 months Assistance with co-pays. Estimated: $25 a month for 4 months Assistance with co-pays. Estimated: $25 a month for 4 months Continue to receive HIV medications through THMP Assistance with Medicare Part D monthly premium. Assistance with Medicare Part D deductible and coinsurance for non THMP formulary medications. Assistance Needed * Federal Poverty Level ** Medicaid assistance programs: Medicaid Qualified Medicare Beneficiary (MQMB), Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB) and Qualified individual (QI) ISSUE #2 ~ NOVEMBER 8, 2006 Page 4 Extra Help (Low Income Subsidy) The Social Security Administration (SSA) and the Centers for Medicare & Medicaid Services (CMS) are working together to provide persons with limited income and resources extra help paying for their prescription drugs. You may be able to get extra help to pay for the premiums, annual deductible, and copayments related to the new Medicare Prescription Drug Program - an average of $3,700 in extra help. Medicare beneficiaries eligible for the extra help have a special enrollment period that allows them to enroll in a plan between May 15 and December 31. MANDATORY ENROLLMENT FOR THMP (ADAP) CLIENTS Participation in a Medicare Prescription Drug Plan is voluntary but for some people enrollment is required in order to continue receiving prescription assistance. Full dual eligible clients will be required to enroll in a Medicare Prescription Drug Plan in order to continue receiving prescription benefits. After January 1, 2006 they will no longer have access to most medications through Medicaid. Texas HIV Medication Program (THMP) clients are required to enroll in a Medicare Prescription Drug Plan. The THMP, which is funded by the Ryan White CARE Act, is considered to be the payer of last resort. Therefore, the Health Resources and Services Administration (HRSA) has mandated that THMP ensure clients utilize all other available resources before accessing the THMP. Individuals who are not dual eligible and do not qualify for the full lowincome subsidy will continue to qualify for the THMP to access their HIV medications as long as they are also enrolled in a Medicare Prescription Drug Plan and continue to meet THMP eligibility requirements. APPLYING FOR EXTRA HELP (LOW INCOME SUBSIDY) Individuals who are eligible for Medicare and do not automatically qualify for the Extra Help/Low Income Subsidy must apply for assistance. Individuals who are Dual or Partial Dual eligible do not need to apply since they will automatically receive it. To apply for the Extra Help, you can contact the Social Security Administration (SSA) toll-free at 1-800-772-1213 (TTY 1-800-325-0778) or visit their website at www.ssa.gov to apply online. There is also a paper application. Please note the SSA will only accept original applications. You will need to contact the SSA if you wish to have an application mailed to you. It is important to apply for the Extra Help. Even if you know you are not eligible you still need to apply. The THMP will require a denial letter for continued enrollment in the program; therefore, it is important for you to keep any approval or denial letter received. Other Ryan White funded agencies providing assistance with co-pays, premiums and/or deductibles for you may also need a copy of the denial letter. ISSUE #2 ~ NOVEMBER 8, 2006 Page 5 Drug Plan Formularies If you need a drug that isn't on a plan's formulary you, your doctor or someone you ask to act on your behalf can call or write to the plan to request that the plan cover the prescription you need. Once your plan receives the request, it has 72 hours (for a standard request for coverage) or 24 hours (for an expedited request for coverage) to make its decision. You can get a realistic estimate of what your yearly drug costs will be by entering the Medicare Claim Number (on your red, white and blue Medicare ID card) and your medications with dosing and quantity in the Medicare Prescription Drug Plan Finder: www.medicare.gov/MPDPF/Home.asp. You can tailor the search to your zip code and find plans that are available at the pharmacy you prefer to use and even save your drug list for future reference. You can also view detailed plan info as well as do a side-by-side total cost comparison of 3 plans at once. If you don’t have a Medicare card you can do a general search which includes some basic eligibility questions and get a reasonable estimate of what your yearly drug costs would be. Or, try the Formulary Finder (www.medicare.gov/MPDPF/Home.asp). Select your state and enter your medications with dosing and quantity to find plan formulary information that includes what cost tier** your medications are in and any restrictions (such as Prior Authorization, Limited Quantity, etc), if applicable. **What are tiers or categories on a Medicare Prescription Drug plan’s drug list (formulary)? Many Medicare drug plans place drugs into different “tiers”. Drugs in each tier have a different cost. Some plans may have more tiers and some may have fewer. Here is an example: Tier 1 2 3 Specialty Tier You Pay Lowest copay Medium copay Higher copay Higher percentage What is Covered Most generic prescription drugs Preferred brand-name prescription drugs Non-preferred brand-name prescription drugs Unique, very high cost drugs Cost Example $ 5.00* $ 28.00* $ 53.00* 25% - 33%* of drug cost *These amounts aren’t actual costs. They are examples of co-payments or coinsurance costs for a 30-day supply. Costs vary by plan and by drug. MEDICARE PRESCRIPTION DRUG PLANS Page 6 Determining the Best Medicare Prescription Drug Plan for You This worksheet is designed to help you identify the Medicare Prescription Drug Plan that best fits your needs. Use the left column to write down the plans that you are interested in. Fill in the monthly premium, yearly deductible and offers coverage during gap columns with the plan information provided (starting on page 8). Multiply your monthly premium by 12 to get the yearly premium cost and then add to the deductible to get your potential yearly plan cost. Put a check mark in the far right column if you want more information on a plan. When you have completed the worksheet, go to www.Medicare.gov or to the plan’s website to get more specific information about each plan. You can also call Medicare (1-800-Medicare) or contact each plan (contact information for each plan starts on page 8) to find out what your actual costs will be. Using the example below, more information is needed on the top three plans. The drug coverage and costs associated with each plan can change so be sure to date the worksheet. EXAMPLE: MEDICARE PRESCRIPTION DRUG PLANS Page 8 Medicare Rx Plan Information The Prescription Drug Plans (PDPs) listed below are those currently offering the most medications commonly prescribed to people with HIV/AIDS (see drug list on pages 11-13). These plans are all stand alone PDPs - the list does not include every plan available to you or any of the plans specific to the Medicare Advantage Plans. Based on your income level and personal resources, you may pay less than the listed premium for these plans. Medicare Advantage Plans (formerly called Medicare + Choice) are managed care plans. They offer complete Medicare-covered health care, including drug coverage, through a single plan. Most of these plans offer extra benefits and lower co-payments than the original Medicare Plan. However, you may have to see doctors or go to hospitals that belong to the plan. Depending on your situation, you may require a plan other than those listed below – talk to your case manager or social worker if you have special needs to consider or if you are currently enrolled in a Medicare managed care plan. For more information about the plans listed below and other available plans go to www.medicare.gov or call 1-800-MEDICARE. Ref # Plan Name & ID Numbers Contact Information AARP MedicareRx Plan UnitedHealthcare P.O. Box 29300, Hot Springs, AR 71903 Members: 1-888-867-5575 (same for TTY/TDD) Non-Members: 1-888-867-5564 1-877-730-4192 (TTY/TDD) Web: www.partdcentral.com/ Contract ID Plan ID Monthly Premium / $0 Premium with Annual Full Low Income Deductible Subsidy?** Coverage in the Gap 1 S5820 021 $ 28.60 No $0 No 2 3 AARP MedicareRx Plan - Enhanced (See contact info above) S5921 193 S5810 158 $ 46.40 No $ 41.60 No $0 $0 Generics No Aetna Medicare Rx Plus Aetna Medicare 980 Jolly Road, Blue Bell, PA 19422 Members: 1-877-238-6211 (same for TTY/TDD) Non-Members: 1-800-445-1796 1-800-628-3323 (TTY/TDD) Web: www.aetna.com/members/medicare/ 4 5 Aetna Medicare Rx Premier (See contact info above) S5810 192 S5715 006 $ 69.70 No $ 55.60 Yes $0 $0 Generics Generics Blue Medicare Rx - Plus HISC - Blue Cross Blue Shield of IL, TX, and NM PO Box 7020, Lawrence, KS 66044 Members: 1-888-579-9373 (same for TTY/TDD) Non-Members: 1-888-579-9373 1-888-579-9375 (TTY/TDD) Web: www.hisc.net/ ISSUE #2 ~ NOVEMBER 8, 2006 Page 9 (continued) Ref # Medicare Rx Plans Contract ID Plan ID Monthly Premium / $0 Premium with Full Low Income Subsidy?** Annual Deductible Coverage in the Gap Plan Name & Contact Information Blue Medicare Rx - Standard (See contact info on previous page) 6 7 8 S5715 009 S5715 005 S5617 192 $ 28.70 No $ 29.60 No $ 35.10 No $ 265 $0 $0 No No Generics Blue Medicare Rx - Value (See contact info on previous page) CIGNATURE Rx Complete Plan CIGNA HealthCare 13650 NW 8th St, Sunrise, FL 33325 Members: 1-800-222-6700 (same for TTY/TDD) Non-Members: 1-800-735-1459 Web: www.cigna.com/health/consumer/medical/cignaturerx/ 9 10 CIGNATURE Rx Plus Plan (See contact info above) S5617 110 S5617 108 S5678 049 $ 26.20 No $ 18.70 Yes $ 27.90 No $0 $ 265 $0 No No No CIGNATURE Rx Value Plan (See contact info above) Health Net Orange Option 2 11 Health Net 950 N. Finance Center Dr., Tucson, AZ 85710 Members: 1-800-806-8811 (same for TTY/TDD) Non-Members: 1-800-606-3604 1-800-929-9955 (TTY/TDD) Web: www.healthnet.com/portal/member/home.do 12 Health Net Orange Option 3 (See contact info above) S5678 094 S5884 020 $ 43.10 No $ 19.80 No $0 $0 Generics No Humana PDP Enhanced 13 Humana Insurance Company 500 West Main Street, Louisville, KY 40202 Members: 1-800-281-6918 (same for TTY/TDD) Non-Members: 1-800-706-0872 1-877-833-4486 (TTY/TDD) Web: www.humana-medicare.com/ 14 Humana PDP Standard S5884-080 (See contact info above) S5884 080 $ 12.70 Yes $ 265 No For more information about these and other Medicare/ Medicare Advantage Prescription Drug Plans or to sign up, call 1-800-Medicare or visit www.medicare.gov. MEDICARE PRESCRIPTION DRUG PLANS Page 10 Medicare Rx Plans Ref # (continued) Contract ID Plan ID Monthly Premium / $0 Premium with Full Low Income Subsidy?** Annual Deductible Coverage in the Gap Plan Name & Contact Information Medco YOURx PLAN 15 P. O. Box 630246, Irving, TX 75063 Members: 1-800-758-4574 (same for TTY/TDD) Non-Members: 1-800-758-3605 1-800-716-3231 (TTY/TDD) Web: www.yourxplan.com/medco/consumer/medicare/ home.jsp?partner=pdp&ws=off S5660 022 $ 31.70 No $ 100 No SAMAscript 16 SAMAscript 13900 Riverport Dr, Maryland Heights, MO 63043 Members: 1-800-605-9208 (same for TTY/TDD) Non-Members: 1-800-605-9208 Web: www.samascript.com/ S7950 022 $ 49.70 No $ 265 No UA Medicare Part D Rx Drug Cov 17 United American Insurance Company 3700 S. Stonebridge Dr, McKinney, TX 75070 Members: 1-866-524-4169 (same for TTY/TDD) Non-Members: 1-866-524-4169 1-866-524-4170 TTY Web: www.uamedicarepartd.com/ S5755 025 $ 40.90 No $0 No 18 UA Medicare Part D Rx Covg - Silver Plan (See contact info above) S5755 060 S5921 192 $ 31.90 No $ 30.20 No $ 265 $0 No No UnitedHealth Rx Basic 19 UnitedHealthcare P.O. Box 29350, Hot Springs, AR 71903 Members: 1-888-867-5562 (same for TTY/TDD) Non-Members: 1-888-867-5561 1-877-730-4203 (TTY/TDD) Web: www.partdcentral.com/united-2007-plans.htm 20 UnitedHealth Rx Basic (See contact info above) S5820 125 $ 43.00 No $0 No **If you are approved for Full Premium Subsidy, you will not pay a monthly premium for plans with a "Yes" in this column. IMPORTANT DATES Nov. 15 - Dec. 31, 2006 Nov. 15 - Dec. 31, 2007 Current Open Enrollment Period Next Open Enrollment Period MEDICARE PRESCRIPTION DRUG PLANS Page 11 HIV/AIDS Drug List The medications listed below are commonly prescribed to people with HIV/AIDS and are included on the formulary for each of the plans listed on pages 8-10. This list is not inclusive of all medications available on all plans and therefore may not include all of the medications that you need. Plans can also make changes to their formularies (covered medications) at any time. Please contact your plan to check coverage of these and other medications or use the Internet to find out for yourself by entering your medications at www.medicare.gov. DRUG CATEGORY / DRUG NAME DRUG NAME continued ANALGESIC & ANESTHETIC Fentanyl transdermal (Duragesic) Morphine sulfate (Roxanol) Lopinavir/Ritonavir (Kaletra) Lamivudine (Epivir, 3TC) Nelfinavir (Viracept) Nevirapine (Viramune) Ritonavir (Norvir) Stavudine (d4T, Zerit) Tenofovir (Viread) Tipranavir (Aptivus) Truvada (Viread/Emtriva) Trizivir (Abacavir, AZT, 3TC) Zalcitabine (HIVID, ddC) Zidovudine (Retrovir, AZT) ANTIRETROVIRAL Abacavir (Ziagen) Amprenavir (Agenerase) Atazanavir (Reyataz) Combivir (Lamivudine/Zidovudine) Delavirdine (Rescriptor) Didanosine (ddI, Videx, Videx EC) Efavirenz (Sustiva) Emtricitabine (Emtriva) Epzicom (Abacavir + Lamivudine) Fosamprenavir (Lexiva) Indinavir (Crixivan) ANTIVIRAL Acyclovir (Zovirax) Cidofovir (Vistide) Copegus (Ribavirin) Famciclovir (Famvir) Ganciclovir (Cytovene) Imiquimod (Aldara) Interferon-Alpha (Intron-A) Pegylated interferon (Pegasys, PEG-Intron) Ribavirin (Copegus) Valacyclovir (Valtrex) Valganciclovir (Valcyte) ANTIFUNGAL Amphotericin B (Fungizone) Clotrimazole (Mycelex, Gynelotrimin) Fluconazole (Diflucan) Itraconazole (Sporanox) Ketoconazole (Nizoral) Terbinafine (Lamisil) ISSUE #2 ~ NOVEMBER 8, 2006 Page 12 HIV/AIDS Drug List DRUG CATEGORY / NAME DRUG NAME continued (continued) ANTIPROTOZOAL Atovaquone (Mepron) Pentamidine (NebuPent) Albendazole (Albenza) Azithromycin (Zithromax) Ceftriaxone (Rocephin) Ciprofloxacin (Cipro) Clindamyacin HCL (Cleocin) Clarithromycin (Biaxin) Diaminodiphenylsulfone (Dapsone) Pyrimethamine (Daraprim) Trimetrexate (NeuTrexin) Doxycycline (Vibramycin) Ethambutol (Myambutol) Levofloxacin (Levaquin) Ofloxacin (Floxin) Paromomycin (Humatin) Rifabutin (Mycobutin) Sulfamethoxazole/Trimethoprim (Bactrim, Septra) ANTIBIOTIC / ANTIBACTERIAL / MYCOBACTERIAL Trimethoprim ANTI-INFLAMMATORY, ANTI-ALLERGY & IMMUNOLOGIC Cyclosporine (Sandimmune) Dexamethasone Filgrastrim (G-CSF, Neupogen) Sargramostim (Leukine) Hydroxyzine HCL Interleukin 2 (Proleukin) Thalidomide (Thalomid, Synovir ) CARDIOVASCULAR Mexiletine HCL Atorvastatin (Lipitor) Dronabinol (Marinol) Erythopoietin (Procrit) Erythropoietin (Epogen, EPO) Fluvastatin (Lescol) Nimodipine (Nimotop) Levocarnitine (Carnitor) Lovastatin (Mevacor) Megesterol Acetate (Megace) Octreotide (Sandostatin) Oxandrolone (Oxandrin) Simvastatin (Zocor) ENDOCRINE / ANABOLIC / METABOLIC Human Growth Hormone (Serostim, Somatropin) Pravastatin (Pravachol) FUSION INHIBITOR Enfuvirtide (Fuzeon, T-20) MEDICARE PRESCRIPTION DRUG PLANS Page 13 (continued) DRUG CATEGORY / NAME HIV/AIDS Drug List DRUG NAME continued GASTROINTESTINAL Cimetidine (Tagamet) Famotidine (Pepcid) Granisetron (Kytril) Mesalamine (Asacol) Ranitidine (Zantac) ONCOLOGY Alitretinoin (Panretin) Bleomycin Sulfate (Blenoxane) Cyclophosphamide (Cytoxan) Daunorubicin, liposomal (DaunoXome) Doxorubicin (Doxil) Etoposide Mitoxantorone (Novantrone) Paclitaxel (Taxol) Prochlorperazine Maleate PSYCHOPHARMACOLOGIC & NEUROLOGIC Amitriptyline HCL Aripiprazole (Abilify) Buspirone (BuSpar) Carbamazepine (Tegretol, Epitol) Citalopram (Celexa) Divalproex (Depakote) Escitalopram (Lexapro) Fluoxetine (Prozac) Gabapentin (Neurontin) Hydroxyzine pamoate (Vistaril) Lamotrigine (Lamictal) Mirtazapine (Remeron) Quetiapine (Seroquel) Risperidone (Risperdal) Seraline (Zoloft) Thioridazine HCL Trifluoperazine HCL Venlafaxine (Effexor XR) Ziprasidone (Geodon) ANXIOLYTICS Eszopiclone (Lunesta) Zolpidem (Ambien) Trazodone HCL The medications listed in this brochure are commonly prescribed to people with HIV/ AIDS but this list is not inclusive of all medications available on all prescription drug plans and therefore may not include all of the medications that you need. Plans can also make changes to their formularies (covered medications) at any time. Please contact your plan to check coverage of these and other medications or you can find out online at www.medicare.gov. MEDICARE PRESCRIPTION DRUG PLANS Page 14 Notes ISSUE #2 ~ NOVEMBER 8, 2006 Page 15 Helpful Resources The information contained herein was compiled to help you find the Medicare Rx plan that best fits your individual needs. This information and more is available online at www.medicare.gov. FOR MORE INFORMATION ON DRUG PLANS: On the Medicare website you can learn how Medicare Rx plans work, review and compare plans, check to see if the prescriptions you need are on a plan’s formulary and enroll in the plan of your choice. You can also access Medicare publications, compare hospitals and nursing homes, order a replacement for a lost card or find a new doctor. If you do not have access to the Internet, the same information/assistance is available by calling 1-800-Medicare (TTY: 1-800-486-2048). Have a list of your prescriptions with dosage information and the address of your pharmacy readily available when you call. FOR MORE INFORMATION ON GETTING EXTRA HELP: Medicare is mailing letters each moth to people who automatically qualify for extra help paying for their prescription drug costs. The Social Security Administration is mailing an application for this extra help to people who are newly eligible for Medicare and have certain incomes, if they don’t qualify automatically. If you didn’t get an application but think you may qualify, you can get more information and request an application by calling the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778), or visit www.ssa.gov. MORE INFORMATION FOR TEXAS ADAP CLIENTS: If you are currently receiving assistance with your HIV medications from the Texas HIV Medication Program (THMP or ADAP), you can contact the program directly at 1-800-255-1090 for additional information and guidelines. MEDICARE PRESCRIPTION DRUG PLANS Page 16 References Medicare: www.medicare.gov Social Security Administration: www.ssa.gov Department of State Health Services, Bureau of HIV/STD Prevention, Texas HIV Medication Program (THMP): www.dshs.state.tx.us/hivstd/meds/medicare.shtm Information on HIV/AIDS drugs: www.AIDSmeds.com and MedlinePlus: www.nlm.nih.gov/medlineplus/druginformation.html Acknowledgements Steve DeCorte, coordinator for The Advocacy Project, was instrumental in developing this tool for Houston’s HIV+ community. The Advocacy Project is a community volunteer coalition that advocates as one voice at the Federal level to raise the visibility of HIV/AIDS related issues and to aid in effecting changes in legislation, appropriations and education. For information about The Advocacy Project, call 832-922-0849 or email theadvocacyproject@swbell.net. Many thanks to the community members who helped by reviewing and commenting on the document as it was being designed. Design and layout of the brochure by Diane Beck, Council Coordinator for the Ryan White Planning Council Office of Support. Phone: 713 572-3724; Email: diane_beck@hctx.net; Website: www.rwpc.org. Publication of this guide was made possible by partial funding from the Ryan White CARE Act, specifically from the Ryan White Planning Council of Harris County and the Houston Regional HIV/AIDS Resource Group. Disclaimer This brochure is not intended to be a directory of all prescription drug programs serving HIV+ persons. Inclusion in the brochure does not imply endorsement by the Ryan White Planning Council, Houston Regional HIV/AIDS Resource Group or The Advocacy Project. In preparing this brochure, we have compiled public information available on the Internet about the plans. Although we have done our best to provide accurate information, changes do occur, and what was correct when we went to print may no longer be correct at the time you are reading the brochure. We ask that you contact The Advocacy Project or e-mail feedback_RWPC@co.harris.tx.us if you have comments or would like the most recent update of this brochure.